| NPI | 1518274398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 63449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 12556) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2018-05-07 |